Mesothelioma is no respecter of sex. Even though mesothelioma is seen as a men’s cancer, the fact is it also strikes women.
But mesothelioma is not an equal-opportunity killer. As mesothelioma researchers have noted, women who develop mesothelioma tend to survive longer than men.
This has led some mesothelioma experts to hypothesize that the better mesothelioma survival rate seen in women is linked to the presence of sex hormones — hormones men either don’t have or have in only small amounts.
Researchers from the University of New South Wales in Australia and the Imam Muhammad ibn Saud Islamic University in Saudi Arabia together looked into this and came to the conclusion that better mesothelioma survival in women could be because of estradiol.
Estradiol and Its Relationship to Mesothelioma
Estradiol is one of the three forms that estrogen can take in a woman’s body. Of those three, estradiol predominates and serves as the main sex hormone.
Writing in the June issue of World Journal of Surgical Oncology, the researchers spelled out their reasons for why they believe estradiol and another female sex hormone, progesterone, may have something to do with longer mesothelioma survival in women.
In their article, the researchers pointed to earlier work conducted by colleagues who explored the role played by estrogen receptors in malignant peritoneal mesothelioma.
The fellow researchers reported a few years back that high levels of estrogen receptor-β can serve as a prognostic sign that the mesothelioma patient is likely to enjoy extended survival.
The earlier researchers further noted that estrogen receptor-β is dependent on estradiol. Consequently, high levels of estrogen receptor-β can only mean there are also high levels of estradiol present throughout the subject’s body, they said.
This prompted the earlier researchers to hypothesize that perhaps the reason patients showing high levels of estrogen receptor-β survive longer is because the associated estradiol has mesothelioma-fighting properties.
And, if so, it would make sense that the women were surviving mesothelioma longer, since their bodies are natural storehouses of estradiol.
A second previous study by the same Australian team investigated progesterone’s effect on mesothelioma. Progesterone is another foundational female steroidal sex hormone. It plays a big part in regulating menstruation and pregnancy.
The research uncovered that progesterone also triggers apoptosis in mesothelioma cells. Apoptosis is a process by which damaged or diseased cells naturally shut themselves down and die in order to save the rest of the body.
Now, in this latest research, the investigators conclude that estradiol and progesterone working either independently or together are able to slow malignant peritoneal mesothelioma.
Younger Woman Live with Mesothelioma Longest
The women with peritoneal mesothelioma who see the best prognoses are those who have not yet entered menopause, the current research team contends.
That is because estradiol and progesterone levels are at their highest in women prior to the onset of menopause. To reach their conclusions, the researchers conducted a retrospective study involving 52 patients with peritoneal mesothelioma.
This cohort had some patients from all three mesothelioma cell variants — epithelial, sarcomatoid, sarcomatoid and biphasic. Each of the patients had been treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at some point between 1996 and 2013.
For purposes of mesothelioma survival analysis, the patients were divided into three groups: 28 males, 15 premenopausal females (50 years of age or younger) and nine postmenopausal females.
After the researchers finished pouring over the data, they determined that the mesothelioma survival median for men was 43 months, but for both groups of women combined it was 60 months.
When the two groups of females were compared, the researchers observed that premenopausal women with peritoneal mesothelioma outlived the postmenopausal women.
In both groups of women, mesothelioma survival was longest among the patients with the epithelial type of mesothelioma.
At the end of it all, the researchers concluded that the therapeutic effects of sex steroid hormones on peritoneal mesothelioma need more investigation.
More investigation also would be worthwhile because it could lead to a new and better mesothelioma treatment, one that involves sex hormones.
